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To determine Dysphoric Milk Ejection Reflex (DMER) incidence. Secondary objectives were to describe the symptom profiles and patient characteristics of DMER and assess DMER familiarity.A prospective observational study of people who initiated breastfeeding after delivery between December 2022 and May 2023 at two hospitals in New York. Participants filled out an Initial Survey, assessing prior DMER familiarity, and recurring DMER Symptoms Surveys, assessing symptom presence, severity, and transiency. Medical records were reviewed for patient demographics and clinical history. Descriptive and basic inferential statistics were performed. A p<0.05 was considered statistically significant.Based on the DMER definition utilized, incidence was 26.9 % (n=21), and symptom severity was mostly very mild to moderate. Those with DMER had similar baseline characteristics to those without, apart from a significantly higher rate of having delivered via cesarean section (71.4.0 vs. 33.3 %, p<0.01). Among the 55 patients who completed the initial survey, 61.8 % were unfamiliar with the condition.DMER is described as brief, abrupt, negative emotions experienced by breastfeeding individuals prior to milk letdown. We found that more than 1 in 4 participants screened positive. Future research could better define, quantify, qualify, and publicize this condition to inform clinical practices and facilitate successful breastfeeding relationships. [ABSTRACT FROM AUTHOR]

There are limited data on how neighborhood-level risk factors affect the likelihood of having prenatal diagnosis. Neighborhood social vulnerability can be quantified and ranked using the social vulnerability index (SVI), a tool that measures the cumulative effect of external stressors in the local environment that may affect health outcomes. The objective of the study was to determine the relationship between SVI and prenatal diagnosis among pregnant patients who received genetic counseling. Retrospective cohort study of all pregnant patients who had genetic counseling at two hospitals in New York between January 2019 and December 2022. For each patient, the address of residence was linked to an SVI score (primary exposure) based on census tract. SVI scores were subdivided into fifths and analyzed categorically. The primary outcome was prenatal diagnosis (yes/no). Multivariable logistic regression was performed. A total of 5,935 patients were included for analysis and 231 (3.9 %) had prenatal diagnosis. On regression analysis, no association between SVI and prenatal diagnosis was observed. Patients who had a diagnostic procedure were more likely to be English speaking (aOR 1.80; 95 % CI 1.13–2.87), carriers of a genetic disorder (aOR 1.94; 95 % CI 1.32–2.86), had increased NT (aOR 6.89; 95 % CI 3.65–13.00), abnormal NIPS (aOR 9.58; 95 % CI 5.81–15.80), or had fetal structural anomalies (aOR 10.60; 95 % CI 6.62–16.96). No differences were seen based on race and ethnicity group, insurance type, or marital status. SVI score does not affect rate of prenatal diagnosis. Findings may differ in other geographic regions and populations. [ABSTRACT FROM AUTHOR]

The effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on placental tissue is unclear. We present a case of symptomatic first trimester SARS-CoV-2 infection in which longitudinal ultrasound images demonstrated diffuse areas of echogenic foci. Her 39-week delivery, following an elective induction of labor, was uncomplicated, and placental pathology evaluation noted extensive calcifications. Such findings are sometimes seen in late and post-term pregnancies and those complicated by smoking, hypertensive disorders, diabetes, and viral infections. In this case, no other potential etiology was identified. Thus, we conclude that placental calcifications may be associated with SAR-CoV-2 infection in early pregnancy. [ABSTRACT FROM AUTHOR]

Objective: We evaluated the associations of the obstetric comorbidity index (OB-CMI) and social vulnerability index (SVI) with severe maternal morbidity (SMM)., Study Design: Multicenter retrospective cohort study of all patients who delivered (gestational age > 20 weeks) within a university health system from January 1, 2019, to December 31, 2021. OB-CMI scores were assigned to patients using clinical documentation and diagnosis codes. SVI scores, released by the Centers for Disease Control and Prevention (CDC), were assigned to patients based on census tracts. The primary outcome was SMM, based on the 21 CDC indicators. Mixed-effects logistic regression was used to model the odds of SMM as a function of OB-CMI and SVI while adjusting for maternal race and ethnicity, insurance type, preferred language, and parity., Results: In total, 73,518 deliveries were analyzed. The prevalence of SMM was 4% ( n  = 2,923). An association between OB-CMI and SMM was observed ( p  < 0.001), where OB-CMI score categories of 1, 2, 3, and ≥4 were associated with higher odds of SMM compared with an OB-CMI score category of 0. In the adjusted model, there was evidence of an interaction between OB-CMI and maternal race and ethnicity ( p  = 0.01). After adjusting for potential confounders, including SVI, non-Hispanic Black patients had the highest odds of SMM among patients with an OB-CMI score category of 1 and ≥4 compared with non-Hispanic White patients with an OB-CMI score of 0 (adjusted odds ratio [aOR] = 2.76, 95% confidence interval [CI]: 2.08-3.66 and aOR = 10.07, 95% CI: 8.42-12.03, respectively). The association between SVI and SMM was not significant on adjusted analysis., Conclusion: OB-CMI was significantly associated with SMM, with higher score categories associated with higher odds of SMM. A significant interaction between OB-CMI and maternal race and ethnicity was identified, revealing racial disparities in the odds of SMM within each higher OB-CMI score category. SVI was not associated with SMM after adjusting for confounders., Key Points: · OB-CMI was significantly associated with SMM.. · Racial disparities were seen within each OB-CMI score group.. · SVI was not associated with SMM on adjusted analysis.., Competing Interests: None declared., (Thieme. All rights reserved.)